Dr. Sorkin's long term goal is to become an independent investigator in an academic medical center, working within an interdisciplinary team and developing and testing interventions and programs designed to improve diabetes quality of care and the self-management of diabetes. Despite a dramatic increase in efforts to improve the quality of diabetes care, no amount of technically competent and humanely delivered medical care will lead to the effective management of diabetes unless patients actively implement treatment regimens in the circumstances of their daily lives. Efforts to increase patients'self-management must focus on the micro-environment of the patient-provider interaction where the treatment decisions are made, as well as the macro-environment of the family and community where a healthy lifestyle must be implemented and maintained. The goal of this 5-year Mentored Research Scientist Development award is to enable the applicant to obtain the necessary skills and training to become an independent health services investigator in improving diabetes self-management by focusing on the interaction between the patient-provider relationship and the patient's informal support network. This career development award will consist of coursework, mentorship, and supervised investigations focusing on 1) describing the social environment of a sample of ethnically/ racially diverse patients with type 2 diabetes, 2) investigating the affect of patients'social environment on a high quality clinical intervention designed to improve treatment adherence and outcomes in diabetes, and modified to be effective among limited-English proficient minority patients;and 3) examining the marital relationship as a unique source of influence and support of patients'self-management. This career development award will allow Dr. Sorkin to aquire additional research skills and experience under the mentorship of nationally and internationally known researchers in a supportive academic environment. Completing these three objectives will enhance her ability to conduct patient-centered research and to achieve her goal of becoming an independent patient-oriented researcher in diabetes.